Friday, March 4, 2016

East London's Homeless: A Retrospective Review of an Eye Clinic for Homeless People

BACKGROUND:

There
is very little published work on the visual needs of homeless people. This
paper is the first study to investigate the visual needs of homeless people in
the UK. Although similar work has been done in other countries, this study is
unique because the United Kingdom is the only country with a National Health
Service which provides free healthcare at the point of access. This study
analysed the refractive status of the sample used, determined the demographics
of homeless people seeking eye care and established if there is a need for
community eye health with access to free spectacle correction in East London.

METHODS:

This
retrospective case study analysed the clinical records of 1,141 homeless people
using the Vision Care for Homeless People services at one of their clinics in
East London. All eye examinations were carried out by qualified optometrists
and, where appropriate, spectacles were dispensed to patients. Data captured
included age, gender, ethnicity and refractive error. Results were analysed
using two-sample t-tests with Excel and Minitab.

RESULTS:

Demographics
of age, gender and ethnicity are described. Spherical equivalents (SE) were
calculated from prescription data available for 841 clinic users. Emmetropia
was defined as SE-0.50DS to +1DS, myopia as SE < -0.50DS, and hyperopia as
SE > +1DS. The majority of clinic users were male (79.2 %, n = 923).
Approximately 80 % (n = 583) of clinic users were white, 10 %
(n = 72) were 'black', 4 % (n = 29) 'Asian' and the remaining 5.6 %
(n = 40) were of 'mixed ethnicity' and 'other' groups. The mean age of females
attending the clinic was significantly lower than that of males
(45.9 years, SD = 13.8 vs' 48.4 years, SD = 11.8) when analysed using
a two-sample t-test (t (317) = 2.44, p = 0.02). One third of service users were
aged between 50-59 years. Myopia and hyperopia prevalence rates were
37.0 % and 21.0 % respectively. A total of 34.8 % of homeless
people were found to have uncorrected refractive error, and required spectacle
correction.

CONCLUSIONS:

This
study has identified a high proportion of uncorrected refractive error in this
sample and therefore a need for regular eye examinations and provision of
refractive correction for homeless people.

Below: Number of eye examinations each year at VCHP

Below: Spherical equivalent for right and left eyes for all in the sample